| NPI | 1962697490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | XIYUN SHAO Attending Physician 917-940-8711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0005X Clinic/Center, Ambulatory Family Planning Facility (Licence: NY 245201) |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care (Licence: NY 245201) |
| 275N00000X Medicare Defined Swing Bed Unit (Licence: NY 245201) | |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2007-09-07 |