| NPI | 1801078894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YELENA MAMEDOVA-BRAZ Medical Director 718-997-1901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NY 061110726) |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2007-11-30 |