| NPI | 1033551932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAMILA AGAYEVA Medical Director 718-336-1909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY AAAASF # 3833) |
| Enumeration Date | 2013-07-22 |
| Last Update Date | 2013-07-22 |