| NPI | 1285632117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAYANK V PATEL Owner 718-823-7135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 202857) |
| Additional Taxonomies | 2086S0129X (Licence: NY 209680) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2014-02-19 |