| NPI | 1740474402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM MACCARONE Credentialing Manager 516-466-0390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2019-01-15 |