| NPI | 1144511908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUANITA ONG LAO Direct Owner 718-789-1116 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 115220) |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2011-04-28 |