| NPI | 1659754885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY E HARTNETT CFO 718-960-9465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: NY 7000255R) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2015-07-07 |