| NPI | 1932890555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAGDY F MAHMOUD Credentialing Coordinator 973-370-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-05-16 |
| Last Update Date | 2023-05-16 |