| NPI | 1740527993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE CLANCY Executive Administrator 877-646-2228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 180648-1) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology |
| 2085N0904X | |
| 2085N0700X | |
| Enumeration Date | 2013-01-08 |
| Last Update Date | 2015-08-24 |