| NPI | 1164720942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYDNEY C. PIERCEY Physician 5412-073-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD22463) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2011-03-03 |
| Last Update Date | 2013-03-07 |