| NPI | 1558615955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ENRIQUE HERNANDEZ Medical Director 917-684-9225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NY 238162) |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2012-11-07 |