NPI | 1730463183 |
---|---|
Entity Type | Organization |
Authorized Contact | LISA PERSAUD Medical Director 212-685-1004 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 254812) |
Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: NY 004553) |
261QP2000X Clinic/Center, Physical Therapy (Licence: NY 032406) | |
Enumeration Date | 2011-10-04 |
Last Update Date | 2011-10-04 |