| NPI | 1063871523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH EDOUARD Nurse Practioner 718-217-7111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 3053411) |
| Enumeration Date | 2016-02-12 |
| Last Update Date | 2016-10-07 |