| NPI | 1740549443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALENTIN RAKSIN President 718-377-5649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NY TUV006253-1) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: NJ 27OA00578000) |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2012-05-15 |