| NPI | 1003121492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARVELL SCOTT Director 212-486-8616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NY 241676-1) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY x005160-2) |
| 171100000X Acupuncturist (Licence: NY 229782-A) | |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2014-02-27 |