| NPI | 1841717618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE KAKOULIDES Direct Owner 631-422-5371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 275213) |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2022-01-20 |