| NPI | 1669359873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AVINASH RAVILLA President 646-887-3138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 364SC2300X Clinical Nurse Specialist, Chronic Care | |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2025-08-19 |
| Last Update Date | 2025-09-03 |