| NPI | 1871742387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GORDON CHARLES DAVIS President 718-253-3322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 171745-1) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 207R00000X Internal Medicine (Licence: NY 171745-1) | |
| 208100000X Physical Medicine & Rehabilitation | |
| 2085B0100X Radiology, Body Imaging | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 2085U0001X Radiology, Diagnostic Ultrasound | |
| 208D00000X General Practice | |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2008-09-09 |