| NPI | 1063779346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA BORRERO Owner/Physician 917-561-0500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine (Licence: NY 254370) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2012-04-11 |