| NPI | 1639335250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA JANE GRADY Physician/Owner 917-685-0187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 219244) |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2008-08-04 |