| NPI | 1508308743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKOLAY TARKHANOV Owner 718-351-6203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 243184) |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2016-11-04 |