| NPI | 1841315868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD IZRAILOV President 973-303-0758 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NJ 25MZ00050400) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2011-06-13 |