| NPI | 1588996607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAWWA S. FRAZIER Owner 718-980-6868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2010-02-01 |
| Last Update Date | 2010-02-01 |