| NPI | 1225615982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERNANDO J DELACRUZ Managing Owner 347-794-0531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2021-03-26 |