| NPI | 1710332911 |
|---|---|
| Doing Business As | 121ST STREET FAMILY HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | PETER GRISAFI President/CEO 718-657-1100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) (Licence: NY 70032465R) |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2016-04-26 |