| NPI | 1164733093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN P GOODE President 347-327-3874 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: MA 233855) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2010-06-25 |