| NPI | 1942520358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID KHASIDY Director 718-618-7522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 163002) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 163002) |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2010-06-08 |