| NPI | 1124499157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAREK M MOUSA President 347-556-7769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NY 259363) |
| Enumeration Date | 2015-10-16 |
| Last Update Date | 2015-10-16 |