| NPI | 1750570032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE HERBERT TOPOL Owner 516-599-4125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NY 005097-1) |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2008-06-10 |