| NPI | 1750519690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN-ROBERT BOURSIQUOT Medical Director 718-507-5656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 156767) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2009-06-30 |