| NPI | 1740971399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELO A. DIMAGGIO Operator/President 718-356-9222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2023-05-16 |
| Last Update Date | 2023-05-16 |