| NPI | 1730457441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL A MCKEOWN Manager/Director 914-747-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: NY 259884) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY A259884-1) |
| 207Q00000X Family Medicine (Licence: NY A259884-1) | |
| Enumeration Date | 2011-12-08 |
| Last Update Date | 2012-06-20 |