| NPI | 1851725758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YEVGENIYA POZHARNY Medical Director 718-521-6415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 244501) |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2013-08-27 |