| NPI | 1386060705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAN H. LEE Executive Officer 718-938-1777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Additional Taxonomies | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2014-03-10 |
| Last Update Date | 2014-03-10 |