| NPI | 1568723377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERNESTO M LOPEZ Medical Director 212-781-5075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NY 123637) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2012-06-07 |