| NPI | 1962707125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP C. BONANNO Director 914-242-7640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 208600000X Surgery | |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2011-01-20 |