| NPI | 1396901211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACIA LOUIS MAYARD Practicioner/ Director And Officer 718-251-3303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NY 151033) |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2008-08-06 |