| NPI | 1972825057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY JUDITH MORENO Manager 609-921-1424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ MA04597200) |
| Enumeration Date | 2010-02-17 |
| Last Update Date | 2011-01-07 |