| NPI | 1790035822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA LOUISE BORRERO RN 718-448-7544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NY 6534571) |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2012-09-17 |