| NPI | 1780166645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA MAZZOTTA CFO 914-941-1263 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2018-09-07 |