| NPI | 1346628278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA VALENTIN Credentialing Manager 212-792-8149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2015-05-12 |