| NPI | 1164151627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY GORDON Managing Partner 718-551-1580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2022-06-08 |
| Last Update Date | 2024-03-05 |