| NPI | 1497833743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN HARTMANN Office Manager 516-328-9800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X (Licence: NY 103844) |
| Additional Taxonomies | 2086S0129X (Licence: NY 131666) |
| 2086S0129X (Licence: NY 195038) | |
| 2086S0129X (Licence: NY 207067) | |
| 363AS0400X Physician Assistant, Surgical (Licence: NY 007572) | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2010-09-29 |