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 |