| NPI | 1396599213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCY LIAO Nurse Practitioner 347-368-0002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2024-04-16 |
| Last Update Date | 2025-09-04 |