| NPI | 1356634554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAMILA AGAYAVA Owner 718-336-1909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 226831) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 238834) |
| Enumeration Date | 2011-05-20 |
| Last Update Date | 2024-02-08 |