| NPI | 1568951960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IGOR MAGANOV Owner 631-264-2030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2018-05-02 |