NPI | 1093801615 |
---|---|
Entity Type | Organization |
Authorized Contact | MARLENA SIMPSON Director Of Credentialing 516-542-6880 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207R00000X Internal Medicine |
207RH0003X Internal Medicine, Hematology & Oncology | |
207RP1001X Internal Medicine, Pulmonary Disease | |
207RR0500X Internal Medicine, Rheumatology | |
207V00000X Obstetrics & Gynecology | |
207W00000X Ophthalmology | |
207X00000X Orthopaedic Surgery | |
208000000X Pediatrics | |
2080P0201X Pediatrics, Pediatric Allergy/Immunology | |
2080P0205X Pediatrics, Pediatric Endocrinology | |
208600000X Surgery | |
208800000X Urology | |
213E00000X Podiatrist | |
Enumeration Date | 2006-10-04 |
Last Update Date | 2020-08-22 |