| NPI | 1609227479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE CLANCY Admin 631-343-4373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 116260-5) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 116260-5) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2017-02-16 |