| NPI | 1851761233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY EMILI Owner 631-737-4168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 211144) |
| Additional Taxonomies | 208VP0000X (Licence: NY 211144) |
| Enumeration Date | 2015-09-29 |
| Last Update Date | 2015-09-29 |