| NPI | 1760907794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW SCOTT GARDNER Owner 212-685-5832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NY 181860) |
| Enumeration Date | 2017-08-10 |
| Last Update Date | 2022-07-21 |