| NPI | 1033178561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NURAH JAHAN ABDUR-RAHMAN Credentialing Coordinator 718-636-4500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2016-03-17 |