| NPI | 1083623409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YEVGENIY STEPANKOVSKIY Chief Executive Officer 718-434-0711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: NY 7001111R) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2024-02-27 |