| NPI | 1013173541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK MICHNIK Owner 917-907-2983 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 236807-1) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 236807) |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2016-05-16 |