| NPI | 1366718009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS M WALCOTT Chancellor 718-831-4024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NY 292215-1) |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2012-03-27 |