| NPI | 1659405710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JR PETER NELSON Executive Director 718-945-7150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NY 070343-1) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-08-22 |