| NPI | 1942329107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARETHA PERSAUD Owner 631-470-7915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NY 228552) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2010-12-28 |