| NPI | 1376981639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN O'CONNOR Credentialing Specialist 347-761-3286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: NY 016528) |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2013-06-10 |