| NPI | 1104098698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE M. BELLO Office Manager 631-321-6801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 203794) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NY 203794) |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2008-03-25 |