| NPI | 1699854992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA LEE SULLIVAN Physician 914-980-2844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 168673) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2013-04-02 |