| NPI | 1629491238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SERGIO ANTONIO MARTINEZ President 917-837-4210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: NY 181742) |
| Enumeration Date | 2014-02-03 |
| Last Update Date | 2014-02-03 |