| NPI | 1912765710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY WHITE BROWN Medical Director 516-640-7401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2024-03-07 |
| Last Update Date | 2024-03-07 |