| NPI | 1730718800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWANDA CURRY-MACK GOEHRING President/Provider 917-502-8345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2020-09-04 |