| NPI | 1871155259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARSIMRAT KAUR BAINS Office Manager,RN 718-964-3919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QA0000X Family Medicine Adolescent Medicine |
| 207QA0505X Family Medicine Adult Medicine | |
| 207QH0002X Family Medicine Hospice and Palliative Medicine | |
| 207QS0010X Family Medicine Sports Medicine | |
| Enumeration Date | 2019-07-05 |
| Last Update Date | 2019-07-05 |