| NPI | 1386351393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER LED'S GISCARD JEROME Cmo 347-455-7845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2024-11-14 |