| NPI | 1730450685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICH PAPPERMAN Provider Enrollment Manager 609-463-8075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 211D00000X Assistant, Podiatric (Licence: NY N002858-1) |
| Enumeration Date | 2012-01-24 |
| Last Update Date | 2012-03-01 |