| NPI | 1508959743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VASANTHA K. KONDAMUDI Shareholder 718-250-8621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2016-12-09 |