| NPI | 1265874515 |
|---|---|
| Doing Business As | NONE |
| Entity Type | Organization |
| Authorized Contact | NIGORA FULLER Owner 914-665-0428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: NY 260385) |
| Enumeration Date | 2013-07-26 |
| Last Update Date | 2013-07-26 |