| NPI | 1245536440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAHLA MALLICK Doctor 718-833-7860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 217612) |
| Enumeration Date | 2011-02-04 |
| Last Update Date | 2024-06-04 |