| NPI | 1154649887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IGOR A TALIS President 718-934-2211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 253007) |
| Enumeration Date | 2010-05-05 |
| Last Update Date | 2010-05-05 |