| NPI | 1881247054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENATO M CAPPELLO Employee/ Sole Member LLC 201-391-8600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2019-07-17 |