| NPI | 1578633822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN TANNEN Administrator 631-751-5724 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2020-08-22 |