| NPI | 1982887717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IGOR PRIVEN President 718-986-6443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NY 220133) |
| Enumeration Date | 2007-12-15 |
| Last Update Date | 2008-10-17 |