| NPI | 1780454017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY J QUILLEN Physician 914-815-1382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 2085R0001X |
| 2085R0203X Radiology, Therapeutic Radiology | |
| Enumeration Date | 2024-01-08 |
| Last Update Date | 2025-02-04 |