| NPI | 1053707091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR GEORGE DEMARCO CFO 718-901-8600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: NY 1067976) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2018-05-30 |