| NPI | 1467812834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILYN CARABAJO Secretary 718-470-7130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: NY 053824-1) |
| Enumeration Date | 2016-02-29 |
| Last Update Date | 2016-02-29 |