| NPI | 1386960052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE CHIARAMONTE Medical Director 718-299-1091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Additional Taxonomies | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2010-04-21 |