| NPI | 1669884748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA RODRIGUEZ Practice Manager 646-457-8127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY F335139-1) |
| Enumeration Date | 2014-05-23 |
| Last Update Date | 2022-05-02 |