| NPI | 1053508994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARETH PINNAMANENI Proprietor 631-589-7787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 194215-1) |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2017-09-22 |