| NPI | 1386678373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF FEOLA Medical Director 718-287-4806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: NY 7735100A) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2020-08-22 |