| NPI | 1134683279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLENA SIMPSON Vice President, Credentialing 516-453-0435 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2019-01-23 |
| Last Update Date | 2019-01-23 |