| NPI | 1235316563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAMON MODESTO TALLAJ Physician 718-294-4008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 204704) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2012-05-15 |