| NPI | 1346938792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY TERRONE Administrator 929-564-8160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-04-25 |
| Last Update Date | 2023-04-25 |