| NPI | 1619934544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WINIFRED MACK CFO 631-968-9000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 207Q00000X Family Medicine | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 208000000X Pediatrics | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2008-08-13 |