| NPI | 1023574589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HESHAM MAHMOUD ATWA Owner 631-476-9296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2019-10-10 |