| NPI | 1164933487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLASUNKANMI BHADMUS Assistant Director 917-374-9180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NY F307489) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F307489) |
| 364SG0600X Clinical Nurse Specialist, Gerontology (Licence: NY 573342) | |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2018-11-02 |