| NPI | 1548292956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANUEL TALAVERA Owner/President 516-616-7600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NY 099616) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2020-08-22 |