| NPI | 1679293443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE LADUCA Credentialing Manager 845-702-2711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology Critical Care Medicine |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine |
| 207RP1001X Internal Medicine Pulmonary Disease | |
| 208600000X Surgery | |
| Enumeration Date | 2022-08-31 |
| Last Update Date | 2025-04-28 |