| NPI | 1144361163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE DEJESUS Member/Owner 347-254-6462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 1724301) |
| Enumeration Date | 2007-02-11 |
| Last Update Date | 2010-08-01 |