| NPI | 1114780525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW LOBOSCO Owner 631-813-7788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2024-01-31 |
| Last Update Date | 2024-01-31 |