| NPI | 1912956905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELIX FERNANDO PACHECO Dr. 551-206-8122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA07566000) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2020-08-22 |