| NPI | 1437353083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYELLEN SCARDINA Billing Coll. Admin. 718-464-4444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 162617-1) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 221341-1) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: NY 162617-1) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 209886-1) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 152401-1) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 111713-1) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 177943-1) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: NY 189088-1) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 208737) | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2007-11-30 |