| NPI | 1811220882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZOYA KOROLEVA Medical Director 718-954-2202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine (Licence: NY 251641) |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2022-01-04 |