| NPI | 1538696372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILYA BURSHTEYN Md 718-459-3494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 2156381) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NY N0060751) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |