| NPI | 1063733863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVAN BRAD GOLDSTEIN Owner 917-570-4437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2013-12-11 |