| NPI | 1922419191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ANTHONY CHIECO Member 917-428-1003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 3400) |
| Enumeration Date | 2014-05-09 |
| Last Update Date | 2023-06-07 |