| NPI | 1114146883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY FITZPATRICK Administrator 516-832-8504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NY 2905200R) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2020-08-22 |