| NPI | 1760777486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD GENNARO DIMASO President 718-356-6500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 170623) |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2011-06-10 |