| NPI | 1861889248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY CONDAL Fiscal Operations Officer 201-634-2680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NJ 2000349) |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2015-04-23 |