| NPI | 1366743239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATEEF GIWA Medical Director 516-695-7172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 119661) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 119661) |
| Enumeration Date | 2010-11-09 |
| Last Update Date | 2010-11-09 |