| NPI | 1164965224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRICK E. ANTELL Medical Director 212-988-4040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY Cert# 1589) |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2016-11-22 |