| NPI | 1215138102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNNMARIE CASTELLANO Office Manager 516-599-9355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NY 205528) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 205528) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2020-08-22 |