| NPI | 1366203028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN AMOS Admin 646-406-9347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2024-01-19 |
| Last Update Date | 2025-06-24 |