| NPI | 1962877472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARAN DEGENHARDT Medical Director 212-366-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 019337) |
| Enumeration Date | 2015-12-09 |
| Last Update Date | 2015-12-09 |