| NPI | 1871684860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLEG OLSHANETSKIY Medical Director 718-244-1644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 215014-1) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-08-22 |