| NPI | 1437859949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY VALEUS Office Manager 631-505-1156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2023-03-06 |
| Last Update Date | 2023-10-24 |