| NPI | 1477868032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN ANTONIO MEDINA President 718-327-3458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 245701) |
| Enumeration Date | 2010-08-06 |
| Last Update Date | 2010-08-06 |