| NPI | 1083992317 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STAFFORD DESMOND JOHN President 718-345-9106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NY 202469) |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2012-03-15 |