| NPI | 1477764496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE DJIBO Director Of Managed Care 212-545-2439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2010-04-28 |