| NPI | 1164436770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN HOWELL GREEN Partner 631-475-8846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 099292) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 101835) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2020-08-22 |