| NPI | 1811713142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANTE HINSON Member Manager 973-798-8280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RA0201X Internal Medicine, Allergy & Immunology | |
| 207RR0500X Internal Medicine, Rheumatology | |
| 207VG0400X Obstetrics & Gynecology, Gynecology | |
| 208000000X Pediatrics | |
| Enumeration Date | 2024-12-02 |
| Last Update Date | 2024-12-02 |