| NPI | 1366730566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN CATIGNANI VP, Provider Services 947-522-0008 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208000000X Pediatrics | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2023-08-23 |