| NPI | 1255266714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWNE BYSHEIM Executive Director 631-786-6094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| 207XS0106X Orthopaedic Surgery, Hand Surgery | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2026-06-16 |
| Last Update Date | 2026-06-16 |