| NPI | 1043589187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY PETER NICOSIA President 772-332-1757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| 207QA0505X Family Medicine, Adult Medicine | |
| Enumeration Date | 2011-12-19 |
| Last Update Date | 2013-03-31 |