| NPI | 1518901180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORRAINE HUMMEL System Director 631-465-6001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology |
| 2085R0202X Radiology, Diagnostic Radiology | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2019-11-04 |