| NPI | 1275075020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITCHELL NETBURN CEO 212-620-0340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: NY 7002161R) |
| Enumeration Date | 2016-11-10 |
| Last Update Date | 2022-02-17 |