| NPI | 1902338460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW MCLEOD Assistant In Surgery 917-726-8554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: VA 0101249738) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2017-04-03 |