| NPI | 1982071619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK JOSEPH LODESPOTO President 631-665-1439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 171063) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 171063) |
| Enumeration Date | 2015-08-28 |
| Last Update Date | 2015-08-28 |