| NPI | 1760750954 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JAANA VIVECA REHNSTROM President 212-366-4765  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NY 167336)  | 
| Enumeration Date | 2011-12-02 | 
| Last Update Date | 2011-12-02 |