| NPI | 1548019185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REWAIS MORCUS Owner 718-450-0515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
| Enumeration Date | 2024-05-16 |
| Last Update Date | 2024-05-16 |