| NPI | 1245766450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA MASAND Resident 516-650-2957 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2017-05-08 |
| Last Update Date | 2017-05-08 |