| NPI | 1124659479 |
|---|---|
| Former Legal Business Name | SIOMS FOREST HILLS |
| Entity Type | Organization |
| Authorized Contact | STEVE YUSUPOV Managing P Artner 718-261-2790 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2020-01-27 |
| Last Update Date | 2020-01-27 |