| NPI | 1972812345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAISA TOUMANOVA Medical Director 646-408-5765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 225064) |
| Enumeration Date | 2010-10-01 |
| Last Update Date | 2010-11-24 |