| NPI | 1609030956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILMANA FULGER Owner/President 914-423-2029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NY 243615) |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2008-07-16 |