| NPI | 1740423508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHALIA IDELEVITCH Medical Director 917-627-5470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2024-01-05 |