| NPI | 1518641752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA ANN MCFARLANE Chief Legal Officer 347-840-0855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-06-08 |
| Last Update Date | 2023-06-08 |