| NPI | 1861762601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMAR DUQMAQ Nurse Practitioner 347-837-1005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 335423) |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2013-02-12 |