| NPI | 1417242579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BIANA GERSHKOVICH President 917-470-1060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NY 020159) |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2011-06-16 |