| NPI | 1033204391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA DEMERS Health Services Tech. 2nd Class 718-354-4414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-08-22 |