| NPI | 1801264817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND SANCHEZ Consultant 917-763-1278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: NY 003417) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health (Licence: NY 212182) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NY 111117) | |
| 261QP3300X Clinic/Center, Pain (Licence: NY 243366) | |
| Enumeration Date | 2015-09-08 |
| Last Update Date | 2015-09-08 |