| NPI | 1174963334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEFAN HAGMANN Medical Director 917-601-0757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NY 245123) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2013-07-02 |