| NPI | 1932789757 |
|---|---|
| Doing Business As | SHARED HARVEST MYCOVIDMD |
| Entity Type | Organization |
| Authorized Contact | NANAEFUA AFOH-MANIN Chief Medical Officer 917-748-3832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2022-08-04 |