| NPI | 1851718779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SURESH MAMIDALA President 917-319-9180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 241829) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 240724) |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2014-04-30 |