| NPI | 1326348608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN LIONNEL VAVAL Physician/ President 718-433-0044 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: NY 163744) |
| Enumeration Date | 2010-11-02 |
| Last Update Date | 2010-11-02 |