| NPI | 1861825572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITCHELL NETBURN CEO 212-620-0340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NY 160611600) |
| Enumeration Date | 2013-08-16 |
| Last Update Date | 2022-02-17 |