| NPI | 1902297468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATHEW JAMES Billing Manager 631-827-8159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Enumeration Date | 2015-02-05 |
| Last Update Date | 2015-02-05 |