| NPI | 1053474395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RITICIA CHRISTINE AUGUSTY Physician Assistant 1718-983-7808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 009897) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2020-08-22 |