| NPI | 1104176312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERARD J. CUSA Owner 516-939-0164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 156842) |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2015-10-13 |