| NPI | 1700098852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUJA JOHNKUTTY Physician 631-385-8558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 216285) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2011-05-16 |