| NPI | 1083942544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER KOTOV Medical Director 646-201-8985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F333427-1) |
| Enumeration Date | 2009-11-21 |
| Last Update Date | 2016-01-12 |