| NPI | 1174715395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OKON E UMANA Medical Director 718-537-3392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NY 153743) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health (Licence: NY 153743) |
| 261QH0100X Clinic/Center, Health Services (Licence: NY 153743) | |
| 261QM1300X Clinic/Center, Multi-Specialty (Licence: NY 153743) | |
| 261QP2000X Clinic/Center, Physical Therapy (Licence: NY 153743) | |
| 261QP2300X Clinic/Center, Primary Care (Licence: NY 153743) | |
| Enumeration Date | 2007-08-11 |
| Last Update Date | 2008-04-20 |