| NPI | 1790244341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLEN EWALT Operations Director 646-970-3538 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2022-11-11 |