| NPI | 1992702377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRIS A JORDAN Office Manager 718-834-1976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NY 124104) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NY 198023) |
| 207W00000X Ophthalmology (Licence: NY 158997) | |
| 207W00000X Ophthalmology (Licence: NY 221505) | |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2015-05-01 |