| NPI | 1790865988 |
|---|---|
| Former Legal Business Name | GARDEN CITY HOSPITAL PROFESSIONAL STAFF PC |
| Entity Type | Organization |
| Authorized Contact | SANDRA KOVALIK Executive Director 313-357-1215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2010-07-20 |