| NPI | 1215480447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCIEN G PRINCE Chief Executive Officer 646-752-2642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 2338331) |
| Additional Taxonomies | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: NY 56004928) |
| 207R00000X Internal Medicine (Licence: NY 231060) | |
| 246QM0706X Spec/Tech, Pathology, Medical Technologist (Licence: NY 0165601) | |
| Enumeration Date | 2016-07-23 |
| Last Update Date | 2016-07-23 |