| NPI | 1740629062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET KRONEMBERG Register Vascular Specialist 631-463-3747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: NY 00081464) |
| Additional Taxonomies | 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2014-04-11 |