| NPI | 1174664940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESE A MALCOLM Sole Proprieter 718-469-0033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 6061762) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2020-08-22 |