| NPI | 1912109877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONATO S RUSSO Owner 908-687-3894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: NJ 25MA05542500) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2020-08-22 |