| NPI | 1730303017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESITA R RODRIGUEZ Chief Executive Officer 212-334-7940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-11-03 |