| NPI | 1811159874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHANAEL DESIRE Owner 631-721-0080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 216602) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 243370) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2008-06-30 |