| NPI | 1003287343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL PARK President 718-446-6579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: NY 209387) |
| Enumeration Date | 2015-10-13 |
| Last Update Date | 2018-12-27 |