| NPI | 1508993650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOFIYA KEISSERMAN Owner/Administrator 718-399-6234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 219313) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV006926) |
| 207R00000X Internal Medicine (Licence: NY 218384) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 127692) | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NY 174588) | |
| 207V00000X Obstetrics & Gynecology (Licence: NY 233517) | |
| 213E00000X Podiatrist (Licence: NY N006039) | |
| 225100000X Physical Therapist (Licence: NY 026957) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2015-04-07 |