| NPI | 1609110295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK J LODESPOTO Owner 631-446-4700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| Enumeration Date | 2012-11-20 |
| Last Update Date | 2013-12-20 |