| NPI | 1336837178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA GEORGE Managing Member 516-360-3248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| Enumeration Date | 2023-04-28 |
| Last Update Date | 2023-09-18 |