| NPI | 1811132343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY A PAPADOPOULOS President 631-493-9390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NY X004540-1) |
| Enumeration Date | 2008-12-12 |
| Last Update Date | 2008-12-12 |