| NPI | 1134352024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW ANGELO JACONO Physician 516-773-4646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2009-08-26 |
| Last Update Date | 2009-08-26 |