| NPI | 1750844239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATHEWS MANCHA Director 201-317-3443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224P00000X Prosthetist |
| Additional Taxonomies | 222Z00000X |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2023-07-25 |