| NPI | 1215268669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAVRIEL FUZAYLOV President 718-897-0327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 200199) |
| Enumeration Date | 2010-01-26 |
| Last Update Date | 2023-07-05 |