| NPI | 1740659408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRES GOMEZ President 347-526-9442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 284300000X Special Hospital |
| Additional Taxonomies | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2023-07-30 |