| NPI | 1861723769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALDINE A MARAJ Administrative Assistant 718-933-1900 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2010-01-18 |
| Last Update Date | 2010-01-18 |