| NPI | 1760841134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATHEW JAMES Billing Manager 631-827-8159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2016-02-15 |