| NPI | 1326375510 |
|---|---|
| Former Legal Business Name | UROLOGY AT LICH |
| Entity Type | Organization |
| Authorized Contact | SUZANNE CASDEN Credentialing Manager 516-569-0696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NY 154270-1) |
| Enumeration Date | 2009-11-09 |
| Last Update Date | 2009-11-15 |