| NPI | 1043769300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAITANYA KADIYALA Owner 646-355-4450 |
| Organization Subpart ? | |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: NY CERT# 4168) |
| Enumeration Date | 2016-09-28 |
| Last Update Date | 2017-04-12 |