| NPI | 1326141110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN GOLD Owner 631-343-4745 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NJ 25MA06659700) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 25MA05185900) |
| 174400000X Specialist (Licence: NJ 25MA07070600) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2023-05-24 |