| NPI | 1174928378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELVIN K JACK President 718-688-8088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 002201) |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2014-10-30 |