| NPI | 1164602397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAYLA SUDAIRI Administrative Director For Billing 646-367-8552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2007-11-05 |
| Last Update Date | 2024-05-29 |