| NPI | 1104229749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILYN VIENTOS-SOTIRIADIS Chief Operating Officer 718-270-2025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| 207Y00000X Otolaryngology | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology | |
| Enumeration Date | 2014-09-26 |
| Last Update Date | 2014-09-26 |