| NPI | 1356610984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIY BAYSHTOK Medical Doctor 718-896-5219 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 157463) |
| Enumeration Date | 2011-12-28 |
| Last Update Date | 2012-02-16 |