| NPI | 1629757919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC YECIES Cco 646-263-3680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2023-07-13 |
| Last Update Date | 2024-05-28 |