| NPI | 1225778442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM CAINE Chief Of Staff 646-625-4531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2022-03-29 |