| NPI | 1093117640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARRETT WESTON Member 646-734-3965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: NY 50050070) |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2014-09-25 |