| NPI | 1639504327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA BEATON Company Owner/ Nurse Practioner 631-499-3223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY F334054-1) |
| Enumeration Date | 2013-09-12 |
| Last Update Date | 2013-12-27 |