| NPI | 1518107945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ORMOND HOSTEN Owner 718-363-6835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: NY 148247) |
| Enumeration Date | 2009-02-25 |
| Last Update Date | 2014-06-20 |