| NPI | 1306387808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA FOX Medical Director 631-820-4360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NY AAAASF #5859) |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2017-03-16 |