| NPI | 1174819171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLGA PROSKUROVSKY Managing Employee 718-653-7100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 248691) |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2011-09-27 |