| NPI | 1477645711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDEL D MCKENNA Administrator 631-694-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NY 5150202R) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2012-05-07 |