| NPI | 1548700925 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILYA KLEYN President 917-554-5735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NY 215006) |
| Enumeration Date | 2017-03-03 |
| Last Update Date | 2017-03-06 |