| NPI | 1487731279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONATO MICHAEL BALSAMO President 631-691-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 209721) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |