| NPI | 1316234669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALENTIN PRIDATKO Do 718-236-5077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NY 205927) |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2011-07-07 |