NPI | 1588104855 |
---|---|
Entity Type | Organization |
Authorized Contact | MIKE SIERRA Supervisor 718-520-8480 |
Organization Subpart ? | No |
Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: NY 232881) |
Enumeration Date | 2017-03-06 |
Last Update Date | 2017-03-06 |