| NPI | 1861026106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE L CUSACK Senior Vice President & CFO 516-321-6058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2022-07-08 |