| NPI | 1861552150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAGGIE TAVDY Physician 718-261-2992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: NY 211927) |
| Enumeration Date | 2006-12-09 |
| Last Update Date | 2020-08-22 |