| 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 |