| NPI | 1811085343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NYUNT SOE Director 718-972-4004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NY 217934) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2009-01-15 |