| NPI | 1023784618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIMON DUONG Physician Assistant 917-682-1932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2021-08-23 |
| Last Update Date | 2021-11-24 |