| NPI | 1831756550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSE TEITELBAUM CFO 917-648-6682 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2022-01-04 |