| NPI | 1063846194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BELLAMY BROOK Medical Director 631-284-3793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: NY 215053) |
| Enumeration Date | 2013-08-26 |
| Last Update Date | 2015-02-12 |