| NPI | 1871822791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN ANTONIO SABIDO Owner 201-223-2308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NJ 25MA07696900) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: NJ 25MA07696900) |
| Enumeration Date | 2009-12-24 |
| Last Update Date | 2012-11-02 |