| NPI | 1578019584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNETTE ELIZABETH CANO-LANDIVAR Medical Doctor 718-704-6299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 281921-1) |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2025-01-13 |