| NPI | 1215384912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE RODRIGUEZ SIMPAO Physician 718-388-7283 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: NY 162398) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 162398) |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2016-05-23 |