| NPI | 1952713281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN GEORGE VELIATH Physician/Owner 631-603-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NY 1634232) |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2014-05-21 |