| NPI | 1720022015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY D GROTH Physician 631-543-1440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 208VP0000X Pain Medicine, Pain Medicine | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2020-11-09 |