| NPI | 1639447030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMERON K ROKHSAR Administrator 516-512-7616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NY 214852) |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2011-12-13 |