NPI | 1740915719 |
---|---|
Entity Type | Organization |
Authorized Contact | YVONNE DAILEY Credentialing Manager 732-244-2775 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
Enumeration Date | 2022-07-22 |
Last Update Date | 2024-01-11 |