| NPI | 1861178790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUSAM WADI Officer 201-378-3608 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2025-01-21 |