| NPI | 1548430325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK LEONARD BAUMGARTEN Controller 917-686-7564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 206669) |
| Enumeration Date | 2008-03-07 |
| Last Update Date | 2008-03-07 |