| NPI | 1366208639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAMRAN SIDDIQUI Chief Executive Officer 516-600-0676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 363LP2300X Nurse Practitioner, Primary Care | |
| 207Q00000X Family Medicine | |
| 363LF0000X Nurse Practitioner, Family | |
| 363L00000X Nurse Practitioner | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2024-02-26 |
| Last Update Date | 2025-09-19 |