| NPI | 1447628342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANISH KUMAR President 718-470-0126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 265895) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: NY 265895) |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2015-12-16 |