| NPI | 1164848453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DMITRIY BRONFMAN Medical Director 718-408-4999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2014-03-11 |
| Last Update Date | 2015-11-15 |