| NPI | 1427347350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AYSAR B FATHALLAH-MAMMO President 516-801-0662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 212576) |
| Enumeration Date | 2011-03-31 |
| Last Update Date | 2011-03-31 |