| NPI | 1811401326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD PETERSON Cbo Director Of Operations 646-605-8145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 2088F0040X Urology, Female Pelvic Medicine and Reconstructive Surgery | |
| 2088P0231X | |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2017-11-20 |