| NPI | 1245743202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMAD JAWAD MIRAN Member 516-810-4496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MD H0083539) |
| Additional Taxonomies | 261QS1200X Clinic/Center, Sleep Disorder Diagnostic (Licence: MD H0083539) |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2018-05-07 |