| NPI | 1598030363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD SEXTUS Director Of Finance 646-845-6041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) (Licence: NY 7002164R) |
| Enumeration Date | 2012-03-13 |
| Last Update Date | 2012-03-13 |