| NPI | 1124316690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE M VASCONEZ PEREIRA Director 212-929-3334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 216012) |
| Enumeration Date | 2011-07-18 |
| Last Update Date | 2011-07-19 |