| NPI | 1407219504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILYA I FISHMAN Owner/Physician 718-644-6778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IL 036118688) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036118688) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2016-04-05 |