| NPI | 1982010468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIREN VANKAWALA Owner 609-365-0730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NJ 25MA07979800) |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2014-07-10 |