| NPI | 1639694805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEHRDAD HEDAYATNIA Owner Authorized Official 718-833-7246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2022-07-21 |