NPI | 1750472171 |
---|---|
Entity Type | Organization |
Authorized Contact | TERRI YANKOSKI Practice Manager 732-577-5558 |
Organization Subpart ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: NJ MA055860300) |
Enumeration Date | 2006-09-28 |
Last Update Date | 2008-07-23 |