| NPI | 1811127194 |
|---|---|
| Doing Business As | MOUNT SINAI ELMHURST FACULTY PRACTICE GROUP |
| Entity Type | Organization |
| Authorized Contact | MARLON E. BREWER Director 718-334-2490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2009-07-21 |