| NPI | 1770553752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY L. ARMENTROUT Clinic Administrator 718-354-4341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient (Licence: VA 0101050128) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2010-09-24 |