| NPI | 1871672980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA SUPONYA President 718-238-8373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NY 229325) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2020-08-22 |