| NPI | 1508045279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA M MARTIN Office Administrator 516-379-3139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NY 112891) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 164466) |
| 207R00000X Internal Medicine (Licence: NY F46077) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 149408) | |
| 363A00000X Physician Assistant (Licence: NY 0107171) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F3019041) | |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2007-10-31 |