| NPI | 1699726315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SERGEI KOCHLATYI Medical Director 718-382-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 218265) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 227059) |
| 208600000X Surgery (Licence: NY 150869) | |
| 208D00000X General Practice (Licence: NY 156598) | |
| 208600000X Surgery (Licence: NY 087860) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2007-10-17 |