| 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 |