| NPI | 1730262536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANUEL BANZON Owner 201-864-4442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NJ MA27187) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2014-03-18 |