| NPI | 1003002759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD M WACKSMAN Medical Director 855-232-0644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| 152W00000X Optometrist | |
| 207R00000X Internal Medicine (Licence: FL ME0086161) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| Enumeration Date | 2007-09-17 |
| Last Update Date | 2021-02-18 |