| NPI | 1730632621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA SMITH President 718-490-0557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NY X009921) |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2016-07-27 |