NPI | 1700911377 |
---|---|
Entity Type | Organization |
Authorized Contact | DORIS VALLEJO Physician 718-515-8600 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NY 189917) |
Enumeration Date | 2007-02-22 |
Last Update Date | 2008-07-15 |