| NPI | 1629384342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIZA GUSEYNOV Physician 718-432-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 233370) |
| Enumeration Date | 2010-08-19 |
| Last Update Date | 2010-08-19 |