| NPI | 1235719063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHINA LUKES-MILLEDGE Nurse Practitioner/Owner 631-455-1965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2021-04-14 |