| NPI | 1285680389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JAMES SMOOK Administrative Manager Third Party 212-442-8468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center Community Health (Licence: NY 7002112R5621) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2020-08-22 |