NPI | 1255610887 |
---|---|
Entity Type | Organization |
Authorized Contact | TOMASINE FODERA Owner 718-815-2300 |
Organization Subpart ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: NY 209637-1) |
Additional Taxonomies | 208600000X Surgery (Licence: NY 204537-1) |
Enumeration Date | 2011-08-13 |
Last Update Date | 2011-08-13 |