| NPI | 1598085508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT GERACI Medical Director 631-852-1869 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local (Licence: NY F3011351-1) |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2010-06-02 |