| NPI | 1588120026 |
|---|---|
| Other Name | HQMP NMG POUGH PCP FM & IM |
| Entity Type | Organization |
| Authorized Contact | GLENN LOOMIS Cmo 845-475-9661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2019-02-20 |