| NPI | 1780086678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMAR TORRES Medical Director 212-673-5633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 018002) |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2014-09-23 |