| NPI | 1619377488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIMOS KANAKOUDAS President 646-824-1380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 60 257261) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 33 337755) |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2019-05-14 |