| NPI | 1356600936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE DOMINGO PAGAN President 631-901-4025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: PR 12860) |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2012-07-05 |