| NPI | 1538922273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIKTORIYA GILYADOVA Manager 718-290-6298 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 247200000X Technician, Other |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2024-02-05 |
| Last Update Date | 2024-03-06 |