| NPI | 1174822589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VLADIMIR MOLIVER President 718-884-8248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 210590) |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2011-03-24 |