| NPI | 1114733664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JOSEPH MAPOY ISADA Ap RN 917-815-0403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2024-12-09 |
| Last Update Date | 2024-12-09 |