| NPI | 1578765517 |
|---|---|
| Former Legal Business Name | NONE |
| Entity Type | Organization |
| Authorized Contact | DENISE ELIZABETH RIGO Family Nurse Practitioner 631-676-6046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NY 333708-1) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2020-08-22 |