| NPI | 1003108358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IMANUEL FUZAILOV PT/Physical Therapist 917-803-5276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 031215) |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2012-05-30 |