| NPI | 1487474284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA BEAUPLAN Owner 631-827-8143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2024-10-15 |
| Last Update Date | 2024-10-15 |