| NPI | 1316505043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN FOWLER CEO 917-216-6285 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 282N00000X General Acute Care Hospital |
| Additional Taxonomies | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2025-06-03 |