| NPI | 1023175981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS VINCENT MCGRATH Manager 516-596-4204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224P00000X Prosthetist |
| Additional Taxonomies | 222Z00000X |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2008-07-17 |