| NPI | 1962431841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKOLAI LAGODUKE Medical Director 718-897-0300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 233906) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2020-08-22 |