| NPI | 1164587127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANATOLIY ABAKIN President 718-331-9600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NY 010303) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-08-22 |