| NPI | 1972046571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATHEW JAMES Billing Manager 631-827-8159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2016-11-30 |