| NPI | 1942825138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELINA KRIVTSOVA Director Credentialing 718-755-6788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2020-11-05 |