| NPI | 1316208127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERNESTO M LOPEZ Medical Director 212-781-5075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: NY 123637) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2012-06-07 |