| NPI | 1477602290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLEY WILLBRANDT Director Shared Services 947-522-1911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| 207X00000X Orthopaedic Surgery | |
| 208600000X Surgery | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2021-02-04 |