| NPI | 1114477817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUGUSTO A ZEVALLOS Medical Doctor 718-418-3335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NY 214540) |
| Enumeration Date | 2016-10-06 |
| Last Update Date | 2016-10-06 |