| NPI | 1598954158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA HARRIS Office Manager 631-321-0033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: NY 211624NY) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2013-05-31 |