| NPI | 1447863303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ATAUL HAKIM CHOWDHURY Medical Director 516-668-8930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2020-08-28 |