| NPI | 1639137854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN BREITSTEIN Provider Enrollment Manager 516-945-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2022-03-03 |