| NPI | 1760058853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARDOSE RANA Owner 732-444-4646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QP3300X Clinic/Center, Pain | |
| Enumeration Date | 2021-05-31 |
| Last Update Date | 2023-02-01 |