| NPI | 1902427479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES R. POWELL CEO 631-650-2087 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 1041C0700X Social Worker, Clinical | |
| 207KA0200X Allergy & Immunology, Allergy | |
| 207N00000X Dermatology | |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism | |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363A00000X Physician Assistant | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2020-05-06 |