| NPI | 1083859425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMASENA L ELLISON Doctor 718-222-0393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 1802491) |
| Enumeration Date | 2008-12-15 |
| Last Update Date | 2014-07-02 |