| NPI | 1932860541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIKI WONG Credentialing Specialist 718-888-9579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 174400000X Specialist |
| 207Q00000X Family Medicine | |
| 207W00000X Ophthalmology | |
| 208100000X Physical Medicine & Rehabilitation | |
| 213E00000X Podiatrist | |
| 225100000X Physical Therapist | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2022-01-05 |
| Last Update Date | 2022-01-05 |