| NPI | 1649516352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED WONG Chief Financial Officer 212-947-5770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2012-12-27 |
| Last Update Date | 2019-06-28 |