| NPI | 1639374390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIMON DAVYDOV Administrator 718-740-0710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2025-09-11 |