| NPI | 1487087979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL M KOEGEL Owner 718-859-3499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 165060) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: NY 165060) |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2013-08-20 |