| NPI | 1902089568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITCHELL L KAPHAN Medical Director 718-418-0300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV006843) |
| 174400000X Specialist (Licence: NY 139985) | |
| 207R00000X Internal Medicine | |
| 261QP2000X Clinic/Center Physical Therapy | |
| 261QX0100X Clinic/Center Occupational Medicine | |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2015-05-04 |