| NPI | 1235897653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROZA BAGDASAROVA Owner 718-406-9032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 305S00000X Point of Service |
| 405300000X Prevention Professional | |
| Enumeration Date | 2021-12-02 |
| Last Update Date | 2022-02-02 |