| NPI | 1851595094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA HOLLANDER Practice Manager 631-864-6647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology Procedural Dermatology |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2007-10-03 |