| NPI | 1447984695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSTAL MCKENNA Director Of Operations 718-362-1406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2022-07-13 |
| Last Update Date | 2022-07-13 |