| NPI | 1790818573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES MICHAEL SHEEHY Executive Director 516-935-1730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NY 147150) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2011-11-10 |