| NPI | 1114376506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE SANTOMASSINO Provider 917-254-1294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2020-07-06 |