| NPI | 1750926911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH BRYANT VP Of Provider Operations 646-293-1873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2019-11-12 |