| NPI | 1215332853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH B CHAPMAN Medical Doctor 718-667-3577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NY 018132-1) |
| Enumeration Date | 2014-10-24 |
| Last Update Date | 2014-10-24 |