| NPI | 1992310411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KWABENA BOAKYE Medical Director 718-220-0900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2020-09-11 |
| Last Update Date | 2021-04-30 |