| NPI | 1740964246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNY SMITH Officer 908-875-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-06-14 |
| Last Update Date | 2025-01-21 |