| NPI | 1730363250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEKSANDR MARTIROSOV Do 201-475-5006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NJ 25MB06860100) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2007-12-19 |