| NPI | 1982136958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAY SANTOS Owner 201-706-3808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00540300) |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2017-03-29 |