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 |