| NPI | 1699146449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVONNE DEACON Director Of Revenue Cycle 631-760-1546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2024-03-05 |