| NPI | 1740630458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QIAONA WENG President 646-732-4119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NY 005543) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: NY 005515) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2016-06-14 |