| NPI | 1346652294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMEL ROMEO Owner 716-316-0998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NY 012404) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2014-05-27 |