| NPI | 1336553221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC ALAN LUBIN Medical Director 646-791-2105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NY 162663) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2014-06-18 |