NPI | 1316355779 |
---|---|
Entity Type | Organization |
Authorized Contact | EUDELL HAYES Credentialing 212-759-4553 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NY 275010-1) |
Enumeration Date | 2014-07-30 |
Last Update Date | 2014-07-30 |