| NPI | 1326158536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY LYNNE MATTHEWS Administrator 516-599-4475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 193204) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2007-08-17 |