| NPI | 1346445947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN POLITO Office Manager 845-343-7529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: NY 044627-1) |
| Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: NY 045048-1) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 051165) | |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2008-04-24 |