| NPI | 1811631591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH WIESENFELD Administrator 718-408-8860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine |
| 163WW0000X Registered Nurse, Wound Care | |
| Enumeration Date | 2022-04-27 |
| Last Update Date | 2023-10-18 |