| NPI | 1093011397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARAJOLLAH MOTAHEDEH Md 718-252-4466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: NY 115284) |
| Enumeration Date | 2011-02-03 |
| Last Update Date | 2014-10-30 |