| NPI | 1013375062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK ALLAN KRAVITZ President 754-702-5348 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: FL ME41286) |
| Enumeration Date | 2016-02-05 |
| Last Update Date | 2016-02-05 |