| NPI | 1073106639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSS BROWN Credentialing Ex 718-313-0438 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology |
| Additional Taxonomies | 261QE0800X Clinic/Center, Endoscopy |
| Enumeration Date | 2021-02-15 |
| Last Update Date | 2023-07-25 |