| NPI | 1487482691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX RAKHMINOV Owner 646-919-1871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2024-07-22 |
| Last Update Date | 2024-07-23 |