| NPI | 1912539578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN SILVERSTEIN Practice Manager 631-617-6011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2020-02-11 |
| Last Update Date | 2020-02-18 |