| NPI | 1295840296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH J TRICARICO President 718-748-3838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NY 118172) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2009-04-09 |