| NPI | 1508005976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY NIL MARTINEZ Facility Administrator 631-647-5550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2009-02-09 |
| Last Update Date | 2023-11-16 |