NPI | 1043428097 |
---|---|
Entity Type | Organization |
Authorized Contact | GREGORY SUPRIN President Medical Director 718-498-3103 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 230165) |
Enumeration Date | 2007-05-21 |
Last Update Date | 2020-08-22 |