| NPI | 1457943862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDMOND VARUZHAN DERDERYAN Md/Co Owner 646-552-1547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2021-02-07 |
| Last Update Date | 2021-02-07 |