| NPI | 1700420700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEISHA ALETHEA BALLENTINE-CARGILL Nurse Practitioner 914-882-7192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2019-11-01 |
| Last Update Date | 2019-11-01 |