| NPI | 1104132778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SVETLANA PROKHOROVA President 718-938-8762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology |
| Enumeration Date | 2010-08-20 |
| Last Update Date | 2011-06-03 |