| NPI | 1407077522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH VITOULIS Owner 516-599-4261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2020-08-22 |