| NPI | 1912054438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN MULLINS President 631-422-5371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery |
| Additional Taxonomies | 207T00000X Neurological Surgery |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2019-10-16 |