| NPI | 1023565991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT GOTLIN Member 212-247-8017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NY 176382) |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2016-09-07 |