NPI | 1942415617 |
---|---|
Entity Type | Organization |
Authorized Contact | NICHOLAS DRIVANOS Executive Director 201-493-7400 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NJ LRR782) |
Enumeration Date | 2007-05-14 |
Last Update Date | 2008-11-25 |