| NPI | 1083961734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN DANIEL ROBERTS President 718-938-3404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2012-08-13 |