| NPI | 1194763763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATAVAN NASIROV Clinic Manager 212-781-5075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 103155-1) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2011-02-15 |