| NPI | 1265971782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMED MAZUMDER President 646-707-7415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 43704) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QA0401X Family Medicine Addiction Medicine (Licence: KY 43704) | |
| Enumeration Date | 2017-02-16 |
| Last Update Date | 2019-03-19 |