Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2010-07-01
- Last updated
- 2016-08-06
Licenses
- License NJ
- MAO59982
- License NJ
- 38MCOO364300
Location
- Practice location
- 516 HAMBURG TPKE, SUITE 5
- City
- WAYNE NJ
- Postal code
- 074702062
- Phone
- 973-790-3000
Organization contact
- Name
- SONIA GOF
- Title
- PRESIDENT
- Phone
- 9737903000
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.