| NPI | 1053187179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET HERON Owner 646-346-4709 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-11-29 |
| Last Update Date | 2023-11-29 |