| NPI | 1194805929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGAR Z VANEGAS Medical Director 718-658-7482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 190283-1) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2013-01-30 |