| NPI | 1548200264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARETTE MENTOR Practice Manager 212-606-1166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 161910-1) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2022-06-06 |