| NPI | 1619374394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUDATH G RANNULU Medical Director 917-972-3247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: TX P7550) |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2014-11-25 |