| NPI | 1184901753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANNY XAVIER RODRIGUEZ Director 718-616-1966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 242152) |
| Enumeration Date | 2011-11-10 |
| Last Update Date | 2012-02-13 |