| NPI | 1154813350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA GRESHAM VP Of Network Operations 212-659-9038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363A00000X Physician Assistant | |
| 207VX0000X Obstetrics & Gynecology Obstetrics | |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2018-06-16 |