| NPI | 1861890493 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARINA ANDRIANOVA Physician 516-512-9435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: NY 272088) |
| Enumeration Date | 2014-12-13 |
| Last Update Date | 2015-02-11 |