| NPI | 1780920041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH STAMM CEO 212-897-6001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NY 153374) |
| Enumeration Date | 2012-12-13 |
| Last Update Date | 2012-12-13 |