| NPI | 1255649950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAX JEAN-GILLES Sole Proprietor 631-643-5382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1800X Clinic/Center, Corporate Health (Licence: NY 165341) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: NY 165341) |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2010-09-16 |