| NPI | 1649562992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAVIER P BURGOS Physician / President 917-518-9445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NY 234448) |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2011-05-04 |