| NPI | 1437305174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YURY FAYDA Owner 718-206-4420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 112714) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 112714) |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2010-01-20 |