| NPI | 1851652887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIONEL BISSOON Officer 212-877-1767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NY 193423) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 012786) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2012-06-06 |