| NPI | 1235408576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TATIANA A PAVLOVA Medical Director 212-569-5330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NY 224668) |
| Enumeration Date | 2011-12-15 |
| Last Update Date | 2011-12-15 |