| NPI | 1912256991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MURL SMITH Cosmotologist 631-264-1408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management (Licence: NY 479242) |
| Enumeration Date | 2012-09-05 |
| Last Update Date | 2012-09-05 |