| NPI | 1871804534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORIS MANSOUR Board Of Directors 201-747-1684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NJ 25MA07927200) |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2010-06-28 |