| NPI | 1679958052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERENCE TEEKAH MAHASE President 718-465-3265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: NY 042201) |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2015-07-27 |