| NPI | 1255879748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAREEF JANDALI Owner 718-672-2824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NJ 25MA10021400) |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2017-02-06 |