| NPI | 1073858742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANJAY SANGWAN Doctor 631-928-2002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 238641) |
| Enumeration Date | 2012-12-06 |
| Last Update Date | 2012-12-07 |