| NPI | 1356707293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER BOKSER Owner 718-274-2749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NY 045876) |
| Enumeration Date | 2016-01-07 |
| Last Update Date | 2016-01-07 |