| NPI | 1235284308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAD JUSTIN JACOBS President 212-831-7770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: NY 175524) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-08-22 |