| NPI | 1275081838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEOGRE HALL President 718-938-3188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 9389049) |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2016-09-13 |