| NPI | 1396455150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANIRUL TAMAL Owner 917-500-3356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2022-12-01 |
| Last Update Date | 2022-12-01 |