| NPI | 1912334434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDIA M CHARLES Owner 973-276-1140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NJ 25MA06235800) |
| Enumeration Date | 2013-09-29 |
| Last Update Date | 2013-09-29 |