| NPI | 1992736300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA BENIQUEZ PACHECO Credentialing Supervisor 201-833-3599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine |
| 207RH0003X Internal Medicine, Hematology & Oncology | |
| 208000000X Pediatrics | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2025-01-24 |