| NPI | 1417758392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY LAWRENCE Business Administrator 631-456-2514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery |
| Enumeration Date | 2025-03-24 |
| Last Update Date | 2025-03-24 |