| NPI | 1891269650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY M. LEGG Credentialing Coordinator 347-584-8903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine |
| Enumeration Date | 2019-01-15 |
| Last Update Date | 2019-03-05 |