| NPI | 1730245366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GORDON C DAVIS Medical Director 718-641-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: NY 24145) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2020-08-22 |