| NPI | 1710300421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE D'ANGELO Billing Mgr 631-465-9333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 237173) |
| Enumeration Date | 2014-01-31 |
| Last Update Date | 2014-01-31 |