| NPI | 1710904701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA DOWD Office Manager 718-748-5219 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NY 7001122R) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2013-08-16 |