| NPI | 1619779709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ENG CEO 917-958-8814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 261QM2500X Clinic/Center Medical Specialty |
| 261QP2000X Clinic/Center Physical Therapy | |
| 261QR0200X Clinic/Center Radiology | |
| 261QR0400X Clinic/Center Rehabilitation | |
| 333600000X Pharmacy | |
| 3336M0002X Pharmacy Mail Order Pharmacy | |
| 207R00000X Internal Medicine | |
| 251V00000X Voluntary or Charitable | |
| 261Q00000X Clinic/Center | |
| 261QA1903X Clinic/Center Ambulatory Surgical | |
| 261QB0400X Clinic/Center Birthing | |
| 261QC1800X Clinic/Center Corporate Health | |
| 261QH0100X Clinic/Center Health Service | |
| 261QP2300X Clinic/Center Primary Care | |
| Enumeration Date | 2025-03-27 |
| Last Update Date | 2025-03-27 |