| NPI | 1780406983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSHIL PANDEY Member Manager 347-239-6581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2024-10-29 |
| Last Update Date | 2025-09-01 |