| NPI | 1508017062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANANA PETROV Director 718-850-6345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| 208100000X Physical Medicine & Rehabilitation | |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2009-01-12 |