| NPI | 1386309268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP ZUZOLO Director Of Clinical Services 800-929-0926 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2021-11-04 |
| Last Update Date | 2021-11-04 |