| NPI | 1710332952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAU NGUYEN President 631-403-2375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NY 247136) |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2016-10-22 |