| NPI | 1801098801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSEMARY GILBERTI Office Manager 631-361-4625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NY F303859) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2007-12-06 |