| NPI | 1598222135 |
|---|---|
| Doing Business As | STATLINE ACCESS LLC |
| Entity Type | Organization |
| Authorized Contact | BRIAN GRUBER Physician Assistant 914-301-3360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2019-03-01 |
| Last Update Date | 2019-03-01 |