| NPI | 1154718757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA M BOLGER Director Of Managed Care 516-495-7129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NY 40508697) |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2021-12-20 |