NPI | 1679094551 |
---|---|
Entity Type | Organization |
Authorized Contact | DINA DICENSO Owner 718-417-1117 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 336930) |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
Enumeration Date | 2017-06-30 |
Last Update Date | 2017-11-30 |