| NPI | 1891969622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA SUN Utilization Management Reviewer 856-779-2332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NJ 44SC05348900) |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2008-04-14 |