| NPI | 1750797890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEHROUZ FARAHMANDPOUR Physician 516-524-2213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: NY 233446) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: NY 233446) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2014-07-09 |