| NPI | 1649314774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS MENDOZA Owner 845-473-4537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NY 145488-3) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2020-08-22 |