| NPI | 1811324650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENE LOUIE PAYUMO President 732-826-4177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NJ 25MA08297000) |
| Enumeration Date | 2013-10-10 |
| Last Update Date | 2013-10-10 |