| NPI | 1861592867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA J. HANSON Office Manager 732-280-7855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Additional Taxonomies | 174400000X Specialist |
| 225100000X Physical Therapist (Licence: NJ 40QA01137200) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2018-03-27 |