| NPI | 1700312774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAD AVSHALOMOV President 718-444-8014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 174400000X Specialist | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2018-04-30 |