| NPI | 1598105983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA WANG Owner 917-991-0319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: GA 070000) |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2014-02-07 |