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 |