NPI | 1174125561 |
---|---|
Entity Type | Organization |
Authorized Contact | MARLENA SIMPSON Sr. Director, Cred & Enrollment 516-207-7851 |
Organization Subpart ? | No |
Primary Taxonomy | 208000000X Pediatrics |
Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
Enumeration Date | 2020-11-11 |
Last Update Date | 2023-02-13 |