| NPI | 1003863820 |
|---|---|
| Doing Business As | MEDICINE SPECIALTY GROUP AT LICH |
| Entity Type | Organization |
| Authorized Contact | VLADIMIR PRIVMAN Managing Employee 718-780-2155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2009-11-03 |