| NPI | 1891720827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN LAURI LEEN Treasurer 973-992-6487 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA01920400) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA01924700) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2008-03-07 |