| NPI | 1245408970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS BLANCO Physician Assistant 212-923-0408 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: NY 0050751) |
| Enumeration Date | 2008-02-15 |
| Last Update Date | 2008-03-10 |