| NPI | 1285465989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYKA SAM Owner 917-588-4798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2024-08-13 |
| Last Update Date | 2024-08-23 |