| NPI | 1942373675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALAH MOHAMED Director 718-859-8808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2020-08-22 |