| NPI | 1528485752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NISON L. BADALOV Owner 718-520-0857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 242278) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2014-03-26 |