| NPI | 1053119479 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | QUINCY K. LEON Program Coordinator 212-746-3970  | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2025-03-03 | 
| Last Update Date | 2025-03-03 |