| NPI | 1578991089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK FACTURA PERALTA Owner 646-675-4671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 242019) |
| Enumeration Date | 2013-10-18 |
| Last Update Date | 2013-10-18 |