| NPI | 1770521270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA SIEBEL CEO 718-234-0073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) (Licence: NY 7001299R) |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty (Licence: NY 7001299R) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2023-02-24 |