| NPI | 1538647896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER HOLOWACH Executive Vice President 718-614-7624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.047318) |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2018-07-30 |