| NPI | 1174702229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH SUSAN SCHILLER Administdrator 631-331-1506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NY 211383) |
| Enumeration Date | 2007-10-25 |
| Last Update Date | 2011-05-09 |