| NPI | 1740946383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FASIKA WALDEAREGAY Physician Owner 631-560-3775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine |
| Enumeration Date | 2021-11-09 |
| Last Update Date | 2021-11-09 |