| NPI | 1588949721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIO FUNICELLI Owner 718-477-9300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NY X007427) |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2014-08-29 |