| NPI | 1528396025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SVETLANA SPIVAK Owner 718-258-9888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 210760) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 210663) |
| Enumeration Date | 2009-11-23 |
| Last Update Date | 2020-10-20 |