| NPI | 1083318000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID RICHARD BEREZNY JR Sole Proprietor/Owner 631-830-4065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2023-04-03 |