| NPI | 1619256864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DREW MALLORY DEMANN Manager 212-935-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 336945) |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2020-11-19 |