| NPI | 1881651081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA L GAVIRIA Billing Supervisor 973-467-3620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NJ 25MA04071400) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2020-08-22 |