| NPI | 1013242726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN ELLIOT CARTER Director, Medicaid & Medicare Reven 212-232-2423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS1000X Clinic/Center, Student Health (Licence: NY 01647043) |
| Enumeration Date | 2009-10-14 |
| Last Update Date | 2009-10-14 |