| NPI | 1881879773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN SPENCE ZUCKERMAN Medical Director 718-423-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 168660) |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2008-03-11 |