| NPI | 1962832485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE CLANCY Executive Administrator 631-983-3934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 175571-1) |
| Additional Taxonomies | 207UN0901X Nuclear Medicine, Nuclear Cardiology |
| 2085U0001X Radiology, Diagnostic Ultrasound | |
| Enumeration Date | 2013-11-19 |
| Last Update Date | 2013-11-19 |