| NPI | 1891044145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTON ROSTOVSKY Medical Director 646-238-0266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 238524) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 238524) |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2012-11-13 |