| NPI | 1245682475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILYA KLEYN Owner 347-689-8880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NY 215006) |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2016-10-16 |