| NPI | 1326389198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERTO DESIRAL President 718-576-6950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NY 031578) |
| Enumeration Date | 2013-03-04 |
| Last Update Date | 2016-12-21 |