| NPI | 1114589793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL EUGENE JONES Medical Director 212-223-0716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2019-07-03 |