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 |