| NPI | 1588309629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE LEE Credentialing Manager 516-616-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2022-05-03 |
| Last Update Date | 2022-05-03 |