| NPI | 1588022438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WEZYANN GAYLE CEO/Owner 646-642-1564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 11080875) |
| Enumeration Date | 2016-02-08 |
| Last Update Date | 2016-02-08 |