| NPI | 1487164885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODI L JACOBS Owner/Operator 914-476-6500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: NY 011379) |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2017-10-11 |