| NPI | 1053501460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOEIN F VASEGHI Director 646-662-1912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NJ 25MA07840500) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: NJ 25MA07840500) |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2021-10-06 |