| NPI | 1164791190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUDHA R SHAH President 718-252-5550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 133672) |
| Enumeration Date | 2011-12-20 |
| Last Update Date | 2012-02-07 |