| NPI | 1699181354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSENDO ICOCHEA President 718-656-2312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2014-07-02 |