| NPI | 1811430523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELLE MARIE CRESSWELL Physician 646-318-1643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA D.O.000165) |
| Enumeration Date | 2016-11-29 |
| Last Update Date | 2016-11-29 |