| NPI | 1629383732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARROLL LESESNE Member 212-570-6318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: NY 161137-2) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2010-08-12 |