| NPI | 1972870475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERBY LUC Lpn Nursing 646-660-2623 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NY 283560) |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2011-11-28 |