| NPI | 1689871238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE L CUSACK Senior Vice President & CFO 516-321-6058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| 207Y00000X Otolaryngology | |
| 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck | |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2020-11-03 |