| NPI | 1366789158 |
|---|---|
| Former Legal Business Name | MASSIMO DEGIARDE MDPC |
| Entity Type | Organization |
| Authorized Contact | JENNIFER HUDSON Administrator 212-966-7193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: NY 140110386) |
| Enumeration Date | 2013-01-14 |
| Last Update Date | 2013-01-14 |