| NPI | 1568651149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAMIRO PINTO Owner/Doctor 631-666-4600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NY 010200) |
| Enumeration Date | 2007-10-18 |
| Last Update Date | 2008-06-20 |