| NPI | 1164133930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM LIPTON VP Practice Management 914-384-2375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2022-12-12 |
| Last Update Date | 2022-12-12 |