| NPI | 1285774752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE GARCIA MADERA Hs3 718-354-4208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |