| NPI | 1881225688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMEN NIEVES-PACHECO Owner 917-309-9184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2020-01-30 |
| Last Update Date | 2020-01-30 |