| NPI | 1700439031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEISHA BALLENTINE-CARGILL Doctoral Nurse Practitioner 914-882-7192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2019-07-16 |