| NPI | 1912047713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN PHYLLIS CHILDS Owner 973-509-6039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA07491800) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2007-08-27 |