| NPI | 1538114707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE WALTZER Chair Person 631-444-1252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2019-06-20 |