| NPI | 1467071654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLENA SIMPSON VP, Credentialing & Enrollment 516-453-0435 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2020-04-09 |