| NPI | 1659487460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARISA KHESINA President 718-380-0011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: NY 203378) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2020-08-22 |