| NPI | 1366735862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY ELIANA WALLACH President / Physician 718-850-9225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine (Licence: NY 224297) |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2011-05-17 |