| NPI | 1225049638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY G JAYASUNDERA Owner 917-214-0084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2016-09-13 |