| NPI | 1154789451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELVIN K JACK President 718-221-5001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NY 272090) |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2016-02-02 |