| NPI | 1164778130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABUL SHAHIDULLAH Owner 718-366-7999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NY 187626) |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2012-07-27 |