| NPI | 1891283511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA BLAIR Business Manager 631-533-5579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LC1500X Nurse Practitioner, Community Health (Licence: NY 320069F) |
| Enumeration Date | 2018-04-27 |
| Last Update Date | 2018-06-16 |