| NPI | 1508162959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY G NINIA Physician 631-331-0500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 174810) |
| Enumeration Date | 2011-02-02 |
| Last Update Date | 2011-02-02 |