| NPI | 1912280389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SELWYN FERGUS Clinical Director 212-378-4545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: NY 133113707) |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2011-09-22 |