| NPI | 1962027078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY LEGG Credentialing COO Rdinator 347-584-8903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Enumeration Date | 2020-06-15 |
| Last Update Date | 2021-05-04 |