| NPI | 1447480439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN ALEXANDER CHARLOTTEN Principal 718-606-0187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 221293) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2011-04-25 |