| NPI | 1255122941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW THOMAS SIEDHOFF President 917-687-4094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology |
| Enumeration Date | 2025-05-13 |
| Last Update Date | 2025-05-13 |