104100000X
Forest Hills, NY
Specialty
104100000X
Credential
L.C.S.W.
NPI
1457682791
111-29 Queens Boulevard, Forest Hills, NY 11375
(718) 275-8900Confirm current license and practice information on the official CMS NPI registry.
View NPI RecordThis surgeon specializes in 104100000x procedures performed in an outpatient ambulatory surgical setting.
NUCC Taxonomy: 104100000X