| NPI | 1891044772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOROTHY LICUL Billing Manager 516-482-4343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 187213) |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2012-09-06 |