| NPI | 1942047865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN WEISS Owner 347-344-7466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2024-07-09 |
| Last Update Date | 2026-04-15 |