| NPI | 1003232091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAUREEN CROWLY Director 631-852-2976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: NY 301585) |
| Enumeration Date | 2014-03-14 |
| Last Update Date | 2014-03-14 |