| NPI | 1326407263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NORMA CECILIA SULLIVAN Registered Nurse 718-592-8275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: NY 315747) |
| Enumeration Date | 2016-02-21 |
| Last Update Date | 2016-04-15 |