| NPI | 1881864528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROCCO FORTUNATO NOTO Medical Doctor 914-245-0256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: NY 160117) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: NY 160117) |
| 302R00000X Health Maintenance Organization (Licence: NY 160117) | |
| 305R00000X Preferred Provider Organization (Licence: NY 160117) | |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2008-07-07 |