| NPI | 1326768698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA DUVAL Administrator 718-433-0044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2022-08-29 |
| Last Update Date | 2025-10-30 |