| NPI | 1710302450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEKSANDER V LAVRENOV President 917-687-7528 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E 5019) |
| Enumeration Date | 2014-03-04 |
| Last Update Date | 2014-03-04 |