| NPI | 1326703331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MA MITCHIELINE MENDOZA MOHABIR President 347-612-6841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2021-11-04 |
| Last Update Date | 2021-11-04 |