| NPI | 1851565741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES E CARLSON Physician/Owner 631-928-9355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 204062) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2008-04-22 |