| NPI | 1649605932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAUDHRY M GHUMMAN Managing Member 718-465-7746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: NY 189683) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: NY 189683) |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2013-09-05 |