| NPI | 1811207475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GIL V. FAJARDO Director 201-453-8777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NJ MA062055) |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2011-01-04 |