| NPI | 1861780751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEONID ISAKOV President 917-652-4020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: 239247) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 245705) |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2013-07-24 |