| NPI | 1316335540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WARREN DANIEL SPINNER Chief Executive Officer/Med. Dir. 631-942-2516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NY 242921) |
| Enumeration Date | 2014-12-22 |
| Last Update Date | 2016-12-13 |