| NPI | 1255483707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD THOMAS BYRNES Vice President/Medical Director 631-864-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 16883) |
| Additional Taxonomies | 2085R0001X (Licence: NY 16883) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2017-11-15 |