| NPI | 1962652685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAJIV V DATTA Director 516-632-3350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 201327) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 200879) |
| 208600000X Surgery (Licence: NY 242239) | |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2008-09-30 |