| NPI | 1780204305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID KNIGHT Owner 917-635-5234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2020-04-23 |
| Last Update Date | 2023-05-17 |