| NPI | 1861660219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BANDANA RAHA Office Manager 201-963-0090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NJ MA41101) |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2008-02-19 |