| NPI | 1003533969 |
|---|---|
| Other Name | LLC |
| Entity Type | Organization |
| Authorized Contact | JESSICA MANCUSO Assistant 914-620-7055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic |
| Enumeration Date | 2022-10-21 |
| Last Update Date | 2023-09-25 |