| NPI | 1760167233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDREY Z PAUL Owner 917-576-7624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2023-06-21 |
| Last Update Date | 2025-12-11 |