| NPI | 1386964492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT GERACI Medical Director 631-852-1869 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NY F301351-1) |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2010-06-11 |