| NPI | 1023206026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANTA MALLIKARJUNA Office Manager 1516-487-5858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 227976-1) |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2007-10-04 |