| NPI | 1770892853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA SIMS Director 718-344-4508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: NY 58014667) |
| Additional Taxonomies | 305S00000X Point of Service (Licence: NY 58-017019) |
| Enumeration Date | 2010-10-06 |
| Last Update Date | 2010-10-06 |