| NPI | 1689450629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES PAINE Chief Executive Officer 917-456-5959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QC1500X Clinic/Center Community Health | |
| 261QP2300X Clinic/Center Primary Care | |
| 3336C0002X Pharmacy Clinic Pharmacy | |
| Enumeration Date | 2023-09-06 |
| Last Update Date | 2023-09-06 |