NPI | 1003154295 |
---|---|
Entity Type | Organization |
Authorized Contact | DARRICK E ANTELL Medical Director 212-988-0463 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NY 161860) |
Enumeration Date | 2013-01-22 |
Last Update Date | 2013-01-22 |