| NPI | 1841347523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY PERCAN Credential 973-402-0025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2013-06-13 |