| NPI | 1265596548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL DELEON Md, VP/Cmo 718-589-2440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2011-03-17 |