| NPI | 1639221039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER MAYER Authorization Department 631-422-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 140169) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2020-08-22 |