| NPI | 1457639916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELINA GRINBERG Dpm 646-441-7309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NY 006327) |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2011-08-11 |