| NPI | 1679962203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARYL STORY Owner 914-888-6662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NY 2773781) |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2015-01-20 |