| NPI | 1689862500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN PRATT DANIEL Owner 718-209-6132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 211396) |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2007-10-11 |