| NPI | 1174650444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ROSE HERNANDEZ Director 718-984-0969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 166698) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2012-12-20 |