| NPI | 1366193567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS LEE President 347-294-3414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2022-01-10 |
| Last Update Date | 2022-01-10 |