| NPI | 1962777565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEYAMMA MATHEW Staff Nurse 718-556-3603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: NY 346200-1) |
| Enumeration Date | 2012-03-14 |
| Last Update Date | 2012-03-15 |