| NPI | 1952739690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBERE EZEANYA Medical Director 973-704-5644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA09219400) |
| Enumeration Date | 2013-10-15 |
| Last Update Date | 2019-08-21 |