| NPI | 1184278798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARSIMRAT KAUR BAINS Office Manager 718-964-3919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0000X Family Medicine Adolescent Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2019-07-31 |