| NPI | 1205222478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NOLAN D TZOU Medical Director 631-629-4440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NY A186571-1) |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2015-04-15 |