| NPI | 1417905969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA DERITIS Certified Medical Manager 631-666-3939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2013-11-08 |