| NPI | 1801251814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSANNA TEDESCO Billing Manager 631-689-6226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 248234) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 462504) |
| 208000000X Pediatrics (Licence: NY 154768) | |
| 208000000X Pediatrics (Licence: NY 60275504) | |
| 208000000X Pediatrics | |
| Enumeration Date | 2015-12-17 |
| Last Update Date | 2015-12-17 |