NPI | 1821757758 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMIE TERRERO Sr. Director Provider Data Mngmt 201-667-5568 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 363L00000X Nurse Practitioner |
104100000X Social Worker | |
363A00000X Physician Assistant | |
Enumeration Date | 2021-12-08 |
Last Update Date | 2023-11-21 |