| NPI | 1912462029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PANSY HARRIS-LANE Owner 973-731-6253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2019-02-02 |
| Last Update Date | 2019-02-02 |