| NPI | 1790979870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER TARNOPOLSKY Physician 267-242-7993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: PA OS010564L) |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2007-08-31 |