| NPI | 1962188938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEYED MORTEZA MAHMOUDI Md 917-297-8603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2023-06-26 |