| NPI | 1295014553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK V BURKE Treasurer 646-921-7211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine |
| 207R00000X Internal Medicine | |
| 207T00000X Neurological Surgery | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2011-08-04 |