| NPI | 1184958712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL POLISENO President 516-375-5904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F333205) |
| Enumeration Date | 2009-09-29 |
| Last Update Date | 2015-08-19 |