| NPI | 1912788613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA Y SMITH Owner 516-284-7521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2023-10-09 |
| Last Update Date | 2024-01-27 |