| NPI | 1730238700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYANNE BOISSONNEAULT Billing Manager 908-232-8077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2022-07-21 |