| NPI | 1770253452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN TIN Administrator 917-336-8422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2021-09-15 |
| Last Update Date | 2022-12-06 |