| NPI | 1902853153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PANDURANG M PRABHU Owner 845-561-2040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: NY 145840) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2022-07-21 |