| NPI | 1790942944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD PATRICK BOUGHAL President 631-261-3243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 149485) |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2008-06-24 |