| NPI | 1275172280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TATYANA RABINOVICH Practice Administrator 718-509-9424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2019-12-23 |
| Last Update Date | 2019-12-23 |