| NPI | 1205597473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA HALLER Manager 516-714-3766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care |
| Enumeration Date | 2022-01-10 |
| Last Update Date | 2022-01-10 |