| NPI | 1629106364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE B. HANGES Administrator 631-424-4004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2020-08-22 |