| NPI | 1821503434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VYACHISLAV ABAYEV Md 917-363-5223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: NY 251705) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 251705) |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2018-01-02 |