| NPI | 1376061176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATHEW JAMES PT. Accounts 631-827-8159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery |
| Enumeration Date | 2017-09-01 |
| Last Update Date | 2022-07-21 |