| NPI | 1700537883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDREY VITAL-ROSADO Rcm Manager 917-647-1665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2022-01-11 |
| Last Update Date | 2025-05-13 |