| NPI | 1891832572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE M. BELLO Office Manager 631-321-6801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery |
| 2086S0129X Surgery, Vascular Surgery | |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2009-11-13 |