| NPI | 1548104482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEEP BHUPENDRA TRIVEDI Medical Director 631-291-1480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 202D00000X Integrative Medicine |
| 208800000X Urology | |
| Enumeration Date | 2026-04-20 |
| Last Update Date | 2026-04-20 |