NPI | 1538821954 |
---|---|
Entity Type | Organization |
Authorized Contact | SAQUIB IBRAHIM Owner 631-935-5295 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 207Q00000X Family Medicine |
Enumeration Date | 2021-10-13 |
Last Update Date | 2021-10-13 |