| NPI | 1861720930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERARD R PERRELLA Sole Member 732-552-9693 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NJ 38MC00604500) |
| Enumeration Date | 2009-11-30 |
| Last Update Date | 2010-09-09 |