| NPI | 1679143820 |
|---|---|
| Former Legal Business Name | LOTUS MEDICAL MANAGEMENT, LLC |
| Entity Type | Organization |
| Authorized Contact | WINTERJANE M PRESTON Clinical Physician Practice Manager 631-512-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2021-06-30 |