NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1114130291
AMERITA OF NEW YORK, LLC.
6912 S QUENTIN ST STE 50
CENTENNIAL
CO
801124531
1427371780
MEDINA
DAVID
75 NASSAU TERMINAL RD
NEW HYDE PARK
NY
110404927
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