| NPI | 1235436130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY J DIEHL President 631-476-7300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NY 1902162) |
| Enumeration Date | 2011-02-12 |
| Last Update Date | 2011-02-12 |