| NPI | 1649670100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE A CONFUSIONE Practice Administrator 3212805867-280-5867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME37806) |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2014-09-02 |