| NPI | 1285264093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAFAEL OSVALDO HERNANDEZ LORA Owner/Physician 718-406-4896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2020-01-21 |
| Last Update Date | 2020-01-21 |