| NPI | 1467864496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVA KHAVKIN President 631-835-9130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NY 190588) |
| Enumeration Date | 2014-05-26 |
| Last Update Date | 2014-05-26 |