| NPI | 1063720910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEHROUZ FARAHMANDPOUR President 631-940-1834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 233446) |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2010-09-14 |