| NPI | 1962228874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEN MAYER Chief Executive Officer 917-373-9448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 261QM2500X Clinic/Center, Medical Specialty | |
| Enumeration Date | 2024-11-25 |
| Last Update Date | 2024-12-04 |