| NPI | 1114204682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARVIN BASE Physician/Principal 718-281-4461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY NY187770) |
| Enumeration Date | 2011-11-10 |
| Last Update Date | 2011-11-10 |