| NPI | 1164074373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN M PUOPOLO Principle Physician 631-689-6698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2019-07-09 |