| NPI | 1770991309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLIE J MOZINGO Practice Manager 908-237-2325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00340900) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2014-07-28 |