| NPI | 1538510466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAE KANG Billing Manager 914-681-9089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NY 6143) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2016-06-22 |