| NPI | 1073913968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIMENG WANG Manager 917-838-1032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NY A234541) |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2014-08-27 |