| NPI | 1457741035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAJESH MARIWALLA Md 631-422-9600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 153786) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 217202) |
| 208000000X Pediatrics (Licence: NY 209194) | |
| 363A00000X Physician Assistant (Licence: NY 008888) | |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2015-02-18 |