| NPI | 1124335278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA M FORTE Director Of Contracting/Credentiali 631-930-9422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NY 145241) |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2011-02-01 |