| NPI | 1164732426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL PROTOMASTRO Board Member 914-227-5360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CT Pending) |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2011-09-16 |