| NPI | 1770687113 |
|---|---|
| Other Name | LIMITED LIABILITY PARTNERSHIP |
| Entity Type | Organization |
| Authorized Contact | JAMAL MAHDAVIAN Surgeon 845-338-2094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2008-06-03 |