| NPI | 1467642140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IMELDA MANGAHAS CRUZ-BANTING Owner 914-779-3710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NY 212537) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: NY 212537) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2007-07-27 |