| NPI | 1164442182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YELENA VORONOVA President 718-554-3862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X (Licence: NY N005994) |
| Additional Taxonomies | 261QP1100X Clinic/Center, Podiatric |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2020-02-06 |