NPI | 1912252602 |
---|---|
Entity Type | Organization |
Authorized Contact | AVIONNE P ALLEN-SINGH President, CEO 866-667-0517 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 207Q00000X Family Medicine |
207QA0505X Family Medicine, Adult Medicine | |
207QG0300X Family Medicine, Geriatric Medicine | |
207R00000X Internal Medicine | |
207RG0300X Internal Medicine, Geriatric Medicine | |
2083P0901X Preventive Medicine, Public Health & General Preventive Medicine | |
213E00000X Podiatrist | |
363A00000X Physician Assistant | |
363L00000X Nurse Practitioner | |
Enumeration Date | 2012-07-18 |
Last Update Date | 2012-07-18 |