| NPI | 1598730889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE MAYER Credentialing Consultant 631-952-5717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism | |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 207RH0003X Internal Medicine, Hematology & Oncology | |
| 207RI0008X Internal Medicine, Hepatology | |
| 207RN0300X Internal Medicine, Nephrology | |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| 207T00000X Neurological Surgery | |
| 208800000X Urology | |
| 208M00000X Hospitalist | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2020-08-22 |