| NPI | 1518307313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN OCONNOR Credentialing Specialist 347-761-3286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NY F337833-1) |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2013-06-26 |