Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2015-04-08
- Last updated
- 2024-05-15
Licenses
- License NJ
- 28RS00739900
- License NJ
- 28RS0073900
Location
- Practice location
- 45 US HIGHWAY 46 STE 610
- City
- PINE BROOK NJ
- Postal code
- 070589390
- Phone
- 877-920-2090
Organization contact
- Name
- DHARA PATEL
- Title
- Owner
- Phone
- 8779202090
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.