| NPI | 1750636221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER E ISTOMIN MD Medical Administrator 718-554-1150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: NY 304254) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: NY 304254) |
| 163W00000X Registered Nurse (Licence: NY 533201) | |
| 163WD0400X Registered Nurse, Diabetes Educator (Licence: NY 304254) | |
| 207P00000X Emergency Medicine (Licence: ZZ 242862) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: ZZ 242862) | |
| 291U00000X Clinical Medical Laboratory (Licence: NY 33D1092118) | |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2015-06-09 |