| NPI | 1831575281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROLANDO RONQUILLO ROMAN Vice President 718-657-8306 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 396583-1) |
| Enumeration Date | 2015-08-08 |
| Last Update Date | 2015-08-08 |