| NPI | 1841425840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MENCIA DISLA Practice Administrator 732-826-5159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ MA034125) |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2019-09-19 |