| NPI | 1730341801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIAVIDA TUPAZ TECSON Owner Physician 973-921-9321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NJ 25MA0747600) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2008-06-30 |