| NPI | 1114668969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHENGJIE MO Family Physician 917-881-0690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2022-06-17 |