| NPI | 1780987610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER RUSANOV Medical Director/President 732-306-1724 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD436215) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD436215) |
| Enumeration Date | 2010-12-15 |
| Last Update Date | 2010-12-15 |