| NPI | 1437583630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARRY S JACOB Owner 516-354-7900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 112426) |
| Enumeration Date | 2013-08-25 |
| Last Update Date | 2013-08-25 |