| NPI | 1437528171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FLIZE ANNEVO BRYAN Physician 718-434-5988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 129936) |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2015-09-25 |