| NPI | 1619091956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEAN LOMBARDO Administrator 631-385-0207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 108320) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 233446) |
| 207Q00000X Family Medicine (Licence: NY 224877) | |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: NY 108320) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: NY 108320) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: NY 155061) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: NY 097663) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NY 155061) | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2013-03-04 |