| NPI | 1396367884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES R. POWELL CEO 631-650-2087 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2020-05-07 |