| NPI | 1982125118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE JOANNA NUNEZ Medical Director 347-334-0906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2023-02-09 |