| NPI | 1700935434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNNEA VILLANOVA Medical Director, Owner 917-880-8518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 203-848) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-08-22 |