| NPI | 1003262148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES MICHAEL INZERILLO Medical Director 631-766-0811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 253084) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY 7420) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 334820) | |
| Enumeration Date | 2016-05-08 |
| Last Update Date | 2016-05-31 |