| NPI | 1588820526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELICIA ANN MENDELSOHN Owner/Sole Proprietor 917-502-6822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NY 60238947) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: CT 046809) |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2011-10-19 |