| NPI | 1639374945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE A GORIS Officer 718-220-2433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 232978) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 190663) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2023-03-07 |