| NPI | 1790156123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL JONES President /Attending Physician 917-447-4922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NY 217144) |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2016-07-14 |