| NPI | 1801927041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANN C DEROSA Billing Manager 201-986-1003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |