| NPI | 1598056129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH CHAMBI JOHNSON Owner 347-756-1696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 244276) |
| Enumeration Date | 2011-04-30 |
| Last Update Date | 2011-04-30 |