| NPI | 1770632879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOV JOHANAN RAND Owner Physician 973-731-8112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225500000X Specialist/Technologist (Licence: NJ 25MA05832500) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2020-08-22 |