| NPI | 1639259385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLENA SIMPSON Director, Credentialing 516-542-6880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 207K00000X Allergy & Immunology |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 207RH0003X Internal Medicine, Hematology & Oncology | |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| 207RR0500X Internal Medicine, Rheumatology | |
| 207V00000X Obstetrics & Gynecology | |
| 207W00000X Ophthalmology | |
| 207X00000X Orthopaedic Surgery | |
| 208000000X Pediatrics | |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology | |
| 2080P0205X Pediatrics, Pediatric Endocrinology | |
| 208600000X Surgery | |
| 208800000X Urology | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2025-09-11 |