| NPI | 1629850250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QAISS MOHAMMED Owner 718-909-7380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2023-10-18 |
| Last Update Date | 2023-12-19 |