| NPI | 1275820086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRAMILA KUMARI KOLISETTY Owner 718-644-4529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 258248) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 240104) |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2021-02-11 |