| NPI | 1801220629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL MCCLUNG Medical Director 917-671-8606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 188795) |
| 363LA2200X Nurse Practitioner, Adult Health | |
| Enumeration Date | 2013-08-28 |
| Last Update Date | 2013-08-28 |