| NPI | 1750430609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARVEY WIEDER President 631-366-3334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NY 206669) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2020-08-22 |