| NPI | 1417340209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARINA RAVICH Medical Director 718-676-7501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 278237) |
| Enumeration Date | 2015-03-18 |
| Last Update Date | 2015-03-18 |