| NPI | 1982839833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ETERI TETROK Owner 718-293-2626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: NY 214065) |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2009-05-21 |