| NPI | 1548706872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE SPRINGER Supervisor 718-734-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 153318) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 114479) |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2017-03-07 |