| NPI | 1790140044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA NIELI Biller 914-376-6100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 23018579) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2015-12-30 |