| NPI | 1902281850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITCHELLE KURK President 718-487-4016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2015-07-21 |