| NPI | 1902265192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NADJA LOUIS JAQUES Staff Physician 516-782-6728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY F336938) |
| Enumeration Date | 2016-02-16 |
| Last Update Date | 2016-02-16 |