| NPI | 1265838254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN KHODADADIAN Owner 516-313-8642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 244392) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 244392) |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2014-11-18 |