| NPI | 1760921712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA EVOLA Np/President 718-496-9946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY TF4601401) |
| Enumeration Date | 2017-02-22 |
| Last Update Date | 2017-02-22 |