| NPI | 1104510791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC YECIES Chief Compliance Officer 646-263-3680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2023-06-06 |
| Last Update Date | 2023-06-06 |