| NPI | 1013962802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY MATHEW Medical Director 516-829-8777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 57561) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2009-09-23 |