| NPI | 1518057546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN WINTER Nurse/Administrator 631-231-4949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NY 5154205R) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2017-04-10 |